Summary: the problem Focus within Scottish general practice on single disease processes and meeting seemingly-arbitrary targets meant patients felt as though their care was fragmented. This focus also impacted staff morale: staff reported feeling feel burnt-out and disillusioned, which can effect recruitment and attrition. Absence of strategic vision for primary care resulted in piecemeal policies that acted as band-aid solutions, without creating lasting change Solution Highlights “House of Care” is a sequence of several interrelated, synergistic strategies, at the core of which is a patient-led care programme design. Patients design their own care plan in consultation with practice nurses. Patients report having more agency. Some patients report an improvement in biomedical markers, as well as overall wellbeing. Staff morale appears to have increased.